Construction of a 73,000-square-foot medical clinic in Waynesville could begin in early spring, the Phelps County Regional Medical Center Board of Trustees heard earlier this month.

"We'd start construction at the end of March or first of April," PCRMC Chief Operating Officer Ellis Hawkins told the board near the end of his presentation at the monthly board meeting. "We'd be on a 14- to 16-month construction schedule."

There's still research and work to be done in the design and development phase, and the board gave its formal approval to continuing that work.

Hawkins said the project would cost an estimated $24 million; $16.6 million would be for construction and $7.5 million would be for furniture, fixtures and equipment.

Chief Financial Officer Ed Clayton said the construction would be paid for with a long-term revenue bond issue and the furniture, fixtures and equipment would be paid for with a lease-purchase plan.

Clayton said the current debt-to-equity ratio is 20.4 percent; borrowing for this construction project would put it at 38.5 percent. The benchmark ratio is 50 percent.

"That would still give us better-than-average leverage," Clayton said, adding that when the 2003 bonds were issued the debt-to-equity ratio was more than 60 percent.

Hawkins opened his presentation with a history of the project's planning.

In the spring of this year, he said, the hospital learned of the opportunity to purchase property highly visible from Interstate 44 in a high-traffic area at Highway H and the Westgate Exchange.

The PCRMC clinic, if constructed, would be adjacent to the Veterans Primary Care Clinic and near the Waynesville High School.

Once that opportunity arose, Hawkins said, "We began developing a business plan."

That plan shows there is a market for PCRMC's services. Hawkins said the business plan looks at non-military population, and outpatient visits are expected to be 16,000 annually with 40,000 clinic visits.

The clinic would include many services, including urgent care and a walk-in clinic, a full imaging suite, cardiac testing services, physicians' offices, physical therapy and a sleep lab.

Hawkins said research is continuing on the possibility of offering dental and optometry services.

In the planning, he said, a hospital-owned and operated pharmacy was considered, but that idea has been shelved. Instead, the research is ongoing on a third-party retail pharmacy.

"We are pleased with the opportunity to expand our world-class services to our Pulaski County community," Hawkins said. "The idea was to make sure we were offering the right services based on the community need in Pulaski County. We tested our business plan, modified the design of the building and added or ruled out services in order to provide the best PCRMC services to our Pulaski County residents."

Craig Schneider, principal in Esterly Schneider Associates Inc., a Springfield-based architectural firm, showed a computerized rendering of the building. It would be a five-level structure with the bottom level being partially underground, although there would be enough above ground to provide natural light.

Page 2 of 2 - Using the computer, Schneider moved around all sides of the building, showing the addition of a parking deck that would add 51 parking spaces on its top and provide covering from the weather on the spaces below.

In addition to those parking spaces there are many more parking spaces around the building.

There's a lane for drive-up window for the pharmacy.

Inside the various levels will have a women's clinic, a physicians' clinic with 23 exam rooms, space for the various services, space for a coffee shop, an atrium entryway.

The top floor would be initially empty, available for expansion of services.

Dr. Donald James, chief medical officer, said there would be 10 physicians at the clinic when it opens, six of them permanently there and four who would be there part-time and at other clinics part-time.

The clinic would also have a nurse-practitioner there, qualifying it as a rural health clinic.

Dr. John T. Park, chairman of the board, said a primary benefit, in his opinion, would be the outreach to Pulaski County, expanding the PCRMC market so it could attract specialists that the hospital currently cannot attract.

By expanding the "catchment" or "drawment" area of the hospital, there is a better chance of adding those specialties at PCRMC, he noted.

Hawkins said the Waynesville city officials have been gracious and good to work with.

"They want it to succeed," he said. Architect Schneider added that the city officials have been willing to grant variances to setback regulations allowing the construction of the clinic and the parking deck closer to the property lines, giving the structures the needed space.

All the board members present — Park, Joanne Brand-Hoertel, Tom Bahr and Albert Crump Jr. — voted for the continuation of the design and development. Ted Day had to leave early, before the discussion of the clinic and the vote. Although the vote was sufficient to pass the motion, Park asked board secretary Brenda Hribar to poll Day for the minutes.